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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, emerged in December 2019, sparking a global health crisis. While initially recognized as a respiratory illness, it has become evident that Coronavirus disease 2019 (COVID-19) also affects the central nervous system. This comprehensive review focuses on the neurological manifestations of COVID-19 and its impact on patients with preexisting neurological disorders, particularly those with multiple sclerosis (MS) receiving disease-modifying therapies. Advancements in management, including vaccinations, antiviral therapy, and targeted prophylaxis, have led to a decline in the incidence and severity of COVID-19. Nevertheless, significant complications persist, particularly in patients with advanced MS, who are highly vulnerable to infectious agents like SARS-CoV-2. This review explores the evolving understanding of MS and its association with SARS-CoV-2, encompassing neuroinvasiveness, pathogenesis, disease severity, and outcomes. Research findings reveal substantial neurological implications for some MS patients with COVID-19, with a potential risk of disease relapse and severity. A notable proportion of MS patients experiencing COVID-19 may manifest new symptoms, experience exacerbation of existing symptoms, or encounter both simultaneously, underscoring the diverse neurological effects of the virus. While vaccination and therapeutics have mitigated the overall impact, specific subgroups, especially those on anti-CD20 therapy and with existing disability, remain at higher risk, necessitating ongoing vigilance and tailored care. [ABSTRACT FROM AUTHOR]

Children with intractable epilepsy have frequent hospital admissions secondary to acute exacerbation of seizures or status epilepticus. Delay in medical management can lead to permanent neurological damage. Randomized clinical trials demonstrate that benzodiazepines are still the cornerstones of the acute management of seizures, but treatment is still evolving owing to the approval of newer medications. A decade ago, approval of fosphenytoin, parental valproate and rectal diazepam made an impact in the acute management of seizures. The use of rectal diazepam and intranasal and buccal midazolam for acute repetitive seizures resulted in reduced hospital admissions. In recent years, intravenous levetiracetum has also had an impact in treating status epilepticus and acute exacerbation of seizures. However, larger, prospective, multicenter trials are required to prove the efficacy of newer agents in acute seizure management., Author(s): Batool F Kirmani [sup.1] Keywords: Keywords * acute repetitive seizure; benzodiazepine; diazepam rectal gel; electroencephalography; fosphenytoin; intranasal midazolam; levetiracetam; phenobarbital; phenytoin; status epilepticus; valproate Acute management of seizures in [...]

The SARS-CoV-2 virus is primarily a respiratory virus, but, as it spread worldwide, it became apparent that there are multiple extrapulmonary manifestations. Reports arose of young and otherwise healthy patients presenting to emergency departments with large-vessel occlusions. Because of a rapidly evolving pandemic, conflicting data sometimes arose regarding the impact of the pandemic on strokes. COVID-19 can induce a hypercoagulable and a proinflammatory state through the interactions with the ACE-2 receptor. These mechanisms may lead to the strokes, both ischemic and hemorrhagic, that are seen in this infection. Strokes, in conjunction with COVID-19 infection, tended to be more disabling and portended a higher mortality. Treatment of these strokes was challenging, as emergency departments were strained with the high burden of COVID-19 admissions. Finally, vaccines against COVID-19 were widely administered, and their potential to cause stroke as an adverse event are discussed. This article will provide an in depth review of the recent updates about the incidence, epidemiology, pathophysiology, clinical presentation and treatment of strokes that are associated with COVID-19., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)